Female Surgeons Achieve Superior Patient Outcomes
Based on the highest quality evidence, female surgeons demonstrate better patient outcomes than male surgeons, with lower mortality rates, fewer complications, and reduced readmission rates. When surgeon characteristics and patient populations are matched, outcomes become equivalent, indicating that the observed differences relate to practice patterns rather than inherent gender superiority.
Evidence for Superior Outcomes with Female Surgeons
A large-scale study of over 100,000 surgical patients found that patients treated by female surgeons had significantly lower rates of death, hospital readmission, and complications within 30 days after surgery compared to those treated by male surgeons, even after matching for patient age, gender, comorbidities, hospital, surgeon age, and surgical volume. 1
Female physicians treating hospitalized Medicare beneficiaries demonstrated significantly lower mortality rates (11.07% vs 11.49%) and lower readmission rates (15.02% vs 15.57%) compared to male physicians within the same hospital. 1
When scaled to 10 million Medicare hospitalizations annually, researchers estimated that 32,000 fewer patients would die per year if male hospitalists achieved the same results as female hospitalists. 1
When Outcomes Are Equivalent
After matching female and male surgeons with similar characteristics who treat similar patients at the same hospital, inpatient mortality, postoperative complications, and prolonged length of stay become equivalent. 2
A study of 2,462 surgeons (19% female, 81% male) at 429 hospitals found that before matching, female surgeons had lower rates of inpatient mortality (1.51% vs 2.30%), any postoperative complication (12.6% vs 16.1%), and prolonged length of stay (18.4% vs 20.7%). 2
However, after matching for surgeon age, experience, hospital, and patient characteristics, these outcome differences disappeared, demonstrating equivalent performance. 2
Practice Pattern Differences
Female surgeons demonstrate different practice patterns that may contribute to improved outcomes:
Female physicians are more likely to provide guideline-concordant care and preventive screening services. 1
Female physicians demonstrate different communication styles and may spend more time with patients, which correlates with better adherence to treatment recommendations. 1
Practice patterns vary by surgeon sex and experience level, with female surgeons being younger (mean age 48.5 vs 54.3 years) and having less clinical experience (11.6 vs 17.6 years) on average. 2
Patient Preferences and Perceptions
Patients do not demonstrate significant overall preference for surgeon gender when professional competence is considered. 3, 4
In a survey of 476 patients, respondents showed no significant preference for either female or male surgeons (P = 0.76). 3
Among 500 women attending breast clinics, only 32% preferred a female breast surgeon for examination, while 73% had no gender preference for actual breast surgery, with surgical ability (93%), experience (91.2%), and knowledge (78.6%) being the predominant selection factors. 4
Younger age and married status were independently associated with same-gender preference for breast examination (OR = 0.978 and OR = 0.563, respectively). 4
Important Caveats
The observed differences in outcomes have important limitations:
The absolute differences in mortality and complication rates, while statistically significant due to large sample sizes, are relatively small and their clinical significance remains debated. 1
Attributing care outcomes to individual physicians is methodologically difficult in complex healthcare systems. 1
Female surgeons face higher operative risk in certain procedures, particularly carotid endarterectomy, where women had less favorable clinical outcomes than men (10.4% vs 5.8% complication rates in ECST). 1
Clinical Recommendation
Patients should select surgeons based on individual competence, experience, and patient-surgeon compatibility rather than gender alone. 2 When female and male surgeons with equivalent training, experience, and practice settings are compared, outcomes are equivalent. The key factors for optimal surgical outcomes include:
- Surgeon technical skill and experience 3, 4
- Hospital quality and resources 2
- Appropriate patient selection 1
- Adherence to evidence-based practices 1
The evidence suggests that increasing diversity in the surgical workforce, including more female surgeons, benefits the healthcare system by providing patients with more options and potentially improving overall care quality through diverse practice approaches. 1